Intensive Early Childhood Education May Boost Adult Health

THURSDAY, March 27, 2014 (HealthDay News) -- Early, intensive education aimed at preparing at-risk children for school may also translate into better health in middle age, a new study suggests.

The research, which is published in the March 28 issue of the journal Science, is the latest finding from the long-running Carolina Abecedarian Project, one of the first tests of early childhood education.

Beginning in the 1970s, researchers enrolled 111 children from low-income, black families in North Carolina.

Before they were even 6 months old, about half the children began attending a special day-care program that was designed to incorporate educational ideas that, at the time, were pretty revolutionary. The aim of the program was to better prepare kids for the demands of school by catching their attention, even as infants, with a series of games designed to stimulate their brains.

For babies, that meant researchers would regularly engage them by talking to them. If the babies started to babble, trained care providers would echo those sounds back to them "to keep the conversation going," explained study author Frances Campbell, a senior scientist at the Frank Porter Graham Child Development Institute at the University of North Carolina. Parents were taught the same techniques to use at home.

Mirrors were hung in cribs so the children could see themselves. And they were given a constantly rotating array of objects to touch and play with. A vegetable scrubber might be used, she said, for its rough texture, while a strap of leather might be chosen for the children to handle because it was smooth.

As the kids grew, they were challenged with a series of simple games that could, for example, require matching shapes or colors.

In addition to the eight hours of daily educational care, five days a week, children were fed twice a day with nutritious, high-quality meals. They also had on-site medical care.

"The minute they started to sniffle, somebody knew it and they were well cared for," Campbell said.

The other half of the kids acted as the "control" group. They didn't come to the same day-care program, but they were given nutritional supplements, social services and access to health care to try to even the playing field. Researchers said they hoped to find out whether their educational ideas were working. They weren't as interested in the benefits of good nutrition or health care.

The first stage of the program lasted until the children were 5 years of age.

Researchers have continued to check on the kids as they've aged, and the early attention appears to have paid off. Kids who attended the day-care classes scored better on tests of intelligence than their peers who didn't get the intensive attention. They also had better reading and math scores throughout their schools years, and were more likely to go to college and to hold skilled jobs.

And the program appears to have had some surprising social benefits as well.

In their early 20s, those who had participated in the early education classes were less likely to be teen parents and less likely to have been involved in criminal activity. They were also less likely to smoke cigarettes or to report using marijuana, the investigators found.

In the latest round of assessments, when study participants were in their mid-30s, researchers gave them thorough physical exams to check on their health. About 72 of the original 111 study participants were available for the latest round of tests, Campbell said.

Once again, the program appears to have paid important dividends, this time in physical health, especially for men.

Boys who had been enrolled in the early childhood education classes as babies were significantly less likely to be obese as children than their peers who didn't get the extra attention.

In their 30s, the men had lower blood pressure and better levels of "good" HDL cholesterol and were less likely to have dangerous combinations of risk factors for heart disease and diabetes such as obesity, high blood pressure and high cholesterol. They also scored lower on tests that measure a person's future heart disease risk, and were more likely to have health insurance and to see a doctor when they were sick.

Women who attended the day-care classes as babies were less likely to have prehypertension. They had lower waist-to-hip ratios and less belly fat, the kind that's thought to be most dangerous for the heart. They also scored lower on tests that measure future heart disease risk, the findings showed.

"I think it's very exciting to see these kinds of results," said Lynn Karoly, a senior economist at the nonprofit RAND Corp. who studies early childhood education. She was not involved in the study.

"We're just learning that what happens in the womb, what happens in those early years, is extremely important for a variety of life course outcomes," Karoly said, including a person's risk for chronic illnesses including heart disease and diabetes.

Karoly did say that a couple of things should be emphasized about the study. It wasn't a simple preschool program.

"This is a very intensive intervention. This is not kids going to a half-day preschool program a year before they go to kindergarten," she said.

The cost of the program, in 2002 dollars, was estimated to be about $67,000 per child -- or about $13,400 per year.

Still, she said, such a hefty investment may very well prove to be worth it over the long run.

"It's probably going to be less expensive to intervene early than it is to correct the problems later in life," Karoly said.

For their part, researchers aren't sure what it was about all that extra attention that may have impacted adult health. But they have some theories.

"We weren't thinking necessarily about health back then, but think what was happening to those children. They were in a fairly stable and predictable environment," Campbell said.

While they were at school, the kids, most of whom were being raised by young, single mothers, didn't have to worry.

"And if you think about disadvantaged children, the culture of poverty, a lot of those children have things going on where they don't know from one minute to the next whether there's going to [be] a fight going on in the house, whether there's going to be supper tonight or whether there will be gunshots in the street. They grow up in an uncertain world in many ways," Campbell said.

She said the center provided a warm, responsive and stable environment.

While the study showed an association between early interventions and health later in life, it did not prove a cause-and-effect relationship.